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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Venous Thrombosis IV: Nursing Management01:30

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Anticoagulation practice patterns in COVID-19: A global survey.

Rachel P Rosovsky1, Kristen M Sanfilippo2, Tzu Fei Wang3

  • 1Department of Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA.

Research and Practice in Thrombosis and Haemostasis
|August 25, 2020
PubMed
Summary

Current practices for managing venous thromboembolism (VTE) in COVID-19 patients vary globally. Most physicians use prophylactic anticoagulation, but more research is needed to establish optimal VTE and bleeding management strategies.

Keywords:
COVID‐19anticoagulantsbleedingblood coagulationvenous thromboembolism

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Area of Science:

  • Internal Medicine
  • Hematology
  • Infectious Diseases

Background:

  • Optimal management of venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19) patients remains unclear due to limited data.
  • Understanding current global practices is crucial for guiding future research.

Purpose of the Study:

  • To assess worldwide physician practices in preventing, diagnosing, and managing VTE in COVID-19 patients.
  • To gather insights for designing prospective and randomized clinical trials.

Main Methods:

  • An online survey was distributed to physicians internationally.
  • The survey focused on prophylaxis, diagnosis, and treatment of VTE in COVID-19 patients.
  • Data were collected from April 10-14, 2020.

Main Results:

  • 515 physicians from 41 countries responded.
  • 78% recommended prophylactic anticoagulation for hospitalized COVID-19 patients, primarily using heparin-based treatments.
  • Observed thrombotic complications (e.g., pulmonary embolism) and bleeding complications were reported, with wide variations in incidence estimates.

Conclusions:

  • Significant variation exists in VTE management approaches for COVID-19 patients.
  • There is an urgent need for well-designed epidemiologic studies and randomized clinical trials to determine optimal anticoagulation strategies and understand VTE/bleeding risks.